Marriage could improve heart attack survival and reduce hospital stay

Being married could improve your likelihood of surviving a heart attack and is associated with reduced length of hospital stay -- according to research presented at the British Cardiovascular Society (BCS) Conference in Manchester today.

The team -- a collaboration between researchers at institutions including Aston Medical School and the University of East Anglia -- found that married people were 14 per cent less likely to die after a heart attack than single people.

Married people were also, on average, likely to spend two fewer days in hospital than single people.

There are 188,000 hospital episodes attributed to heart attack in the UK each year, which is around one every three minutes. Improvements in diagnosis and treatment driven by research mean that around seven out of 10 people now survive a heart attack.

Researchers studied over 25,000 patients with a heart attack diagnosis that took place between January 2000 and March 2013.

The study was performed by the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) Study Unit. The algorithm has compiled a one million patient dataset utilising Hospital Episode Statistics (HES) data from the North of England.

It is not clear from this research why married people are more likely to survive a heart attack but the researchers feel the findings emphasise the importance of physical and emotional support after the event. Although previous studies have linked marriage to improved heart attack outcomes, this is the first study to suggest that marital status affects how quickly heart attack patients are discharged.

Being discharged from hospital sooner could be financially beneficial to the NHS -- the average cost per day for a patient to stay on a surgical ward is up to £400 and it is estimated that reducing length of stays in cardiology alone could save the NHS up to £9.8 million. And shorter stays can benefit patients as they are associated with a lower risk of hospital-acquired infections.

The researchers say that the results show the need for doctors to consider the psychosocial effects of a heart attack, and consider them as a risk factor, when treating and managing the discharge of a patient.

Dr Nicholas Gollop, from UEA's Norwich Medical School, said: "Our results should not be a cause for concern for single people who have had a heart attack. But they should certainly be a reminder to the medical community of the importance of considering the support a heart attack survivor will get once they're discharged."

The researchers hope to expand the ACALM dataset in future studies, where they will look at longer term outcomes and consider the impact of marital status on other heart conditions such as heart failure and also evaluate the impact of potential interventions such as cardiac rehab.

Dr Rahul Potluri, founder of the ACALM Study Unit and clinical lecturer at Aston Medical School, said: "Our approach has already helped us perform research investigating the relationship between mental and physical health, and health services research particularly looking at the weekend effect. Utilising and analysing large data sets is essential to improve our understanding of medical conditions and to improve management options for patients.

"By looking at how larger numbers of heart attack patients do over a longer period of time in future research, we may be able to see additional psychosocial benefits of marriage, which can be targeted to further guide patient care."

Recently a survey of BHF supporters found that one in three (30 per cent) heart attack survivors has suffered with anxiety or depression.

Dr Mike Knapton, associate medical director at the British Heart Foundation (BHF), said: "A heart attack can have both devastating physical and psychological effects -- most of which are hidden from the outside world. These findings suggest the support offered by spouse can have a beneficial effect on heart attack survivors, perhaps helping to minimise the impact of a heart attack.

"When you have your heart attack, whether you're married or not, it's important to remember that you are not alone. Enrolling on a cardiac rehabilitation course, for example, will help you to recover physically, psychologically, and also help you to meet people with similar experiences, who know what you've been through. At the BHF we would encourage all heart attack survivors to do cardiac rehab."

'The impact of marital status on mortality and length of stay in patients admitted with myocardial infarction' will be presented at the British Cardiovascular Society Conference on Wednesday, June 8, 2016.